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Value Plans
When is a bargain not a bargain? Health plans are not created equal. And some products that appear to be insurance, such as discount plans, aren't insurance at all.
Shargel & Co. does not sell discount plans. We also advise against plans that limit pharmacy and maternity benefits. We advise buyers to beware of certain products. It's necessary to read the fine print.
Discount Plans
There are many companies - not insurers - offering discount plans for health care services.
These plans usually have some sort of physician network that purportedly offers discounts off of list prices for services for a monthly fee. These plans are not insurance and do not protect against the financial impact of major health events. Read the fine print!
Discount Pharmacy Plans
Discount pharmacy plans offer discounts off retail pricing on prescription medications for a monthly fee.
These may be useful for uninsured persons who require ongoing medication. Again, reading the fine print is essential before purchasing a discount plan. It is not insurance.
A free discount plan available to all Californians is the California Rx Card, which is sponsored by California Choice. It can be helpful for people without insurance or whose insurance does not cover brand name or non-formulary drugs.
"Mini-med" plans
Mini-med plans are offered by true insurers, but are not true insurance against major health risks.
They usually cover only routine care and limited pharmacy if any. They do not provide coverage for catastrophic medical services. If you have limited premium dollars, a high-deductible plan that covers basic preventive care is a better option.
Limited Pharmacy Plans
Many carriers now offer limited pharmacy plans, in a variety of configurations.
Some cover generic drugs only, others also cover brand drugs up to a dollar limit, and others offer no prescription coverage at all.
These plans are cheaper than full prescription coverage plans, but do not provide full protection. Once you need medication for a chronic condition, you're likely to become uninsurable and will be unable to transfer to a plan with comprehensive pharmacy coverage.
Non-Maternity Plans
In the individual market, an increasing number of plans do not cover maternity services.
This becomes a complicated issue if the insured becomes pregnant or wishes to become pregnant at a later time. Carriers may offer a free transfer to a high-deductible plan within a limited time period, but out-of-pocket costs will be high.